Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.16/1822
Título: Posttransplant allosensitization in low immunological risk kidney and kidney-pancreas graft recipients.
Autor: Malheiro, J.
Tafulo, S.
Dias, L.
Martins, L.
Fonseca, I.
Almeida, M.
Pedroso, S.
Freitas, F.
Beirão, I.
Castro-Henriques, A.
Cabrita, A.
Data: 2014
Editora: Hindawi Pub. Co.
Citação: NCBINCBI Logo Skip to main content Skip to navigation Resources How To About NCBI Accesskeys Sign in to NCBI PubMed US National Library of Medicine National Institutes of Health Search database Search term Create RSSCreate alertAdvanced Help Result Filters Abstract Send to: See 1 citation: Biomed Res Int. 2014;2014:438945
Resumo: INTRODUCTION: Posttransplantation allosensitization prevalence and effect on kidney grafts outcomes remain unsettled. METHODS: Between 2007 and 2012, 408 patients received a primary kidney graft (with 68 patients also receiving a pancreas graft) after a negative cytotoxic crossmatch. All patients had a pretransplant negative anti-HLA screening and 0% panel reactive antibodies. We analyzed retrospectively the results of anti-HLA antibodies screening by Luminex assay, performed between 6 and 24 months after transplant, and searched for the risk factors for antibody positivity and its impact on kidney graft outcomes. RESULTS: Anti-HLA antibodies prevalence at 6 months was 17.4%. Previous steroid-insensitive acute rejection was the only risk factor for both anti-HLA classes detected antibodies. Antithymocyte globulin induction was also a risk factor for anti-HLA-I antibodies. Antibody positivity status was associated with reduced graft function at 12 months and graft survival at 5 years (91.5% versus 96.4%, P = 0.03). In multivariable Cox analysis, delayed graft function (HR = 6.1, P < 0.01), HLA mismatches >3 (HR = 10.2, P = 0.03), and antibody positivity for anti-HLA class II (HR = 5.1, P = 0.04) or class I/II (HR = 13.8, P < 0.01) were independent predictors of graft loss. CONCLUSIONS: Allosensitization against HLA class II ± I after transplant was associated with adverse kidney graft outcomes. A screening protocol seems advisable within the first year in low immunological risk patients.
Peer review: yes
URI: http://hdl.handle.net/10400.16/1822
DOI: http://dx.doi.org/10.1155/2014/438945
ISSN: 2314-6141
2314-6133
Versão do Editor: http://dx.doi.org/10.1155/2014/438945
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